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Cam's Cards COPY > PID and Abuse Case > Flashcards

PID and Abuse Case Flashcards

1
Q

A complication of PID causes RUQ pain?

A

Fitz-Hugh-Curtis Syndrome

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2
Q

What is the cause of the RUQ pain is FHCS?

A

Inflammation of the liver capsule and peritoneal surfaces of the anterior RUQ.

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3
Q

What would you see in laparoscopy or a liver biopsy in patients with FHCS?

A

Violin string like adhesions of the liver capsule

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4
Q

Classic finding in PID?

A

Chandelier sign

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5
Q

What two infections are most commonly associated with FHCS?

A

Gonorrhea and chlamydia.

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6
Q

T/F? Chancres are typically very painful.

A

False - painless although they look painful

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7
Q

A single chancre and regional adenopathy is suggestive of what type of syphilis?

A

Primary

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8
Q

Preferred treatment of primary syphilis?

A

Pen G benzathine 2.4 million units IM once

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9
Q

Secondary syphilis includes what symptoms?

A

Systemic illness, rash involving hands and soles, fever, malaise.

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10
Q

Treatment for secondary syphilis?

A

Pen G benzathine 2.4 million units IM once

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11
Q

What is latent syphilis?

A

+ treponema pallidum testing w/o symptoms.

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12
Q

Difference between early and late latent syphilis?

A

Early < 1 year from initial infection

Latent >1 year from initial infection

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13
Q

Treatment for early latent syphilis?

A

Pen G benzathine 2.4 million units IM once

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14
Q

Tertiary syphilis presents with what symptoms?

A

Late syphilis with manifestations involving the cardiovascular system or gummatous disease (disease of skin, subq tissues, bones, or viscera)

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15
Q

Treatment for tertiary syphilis and late latent syphilis?

A

Pen G benzathine 2.4 million units IM once weekly for 3 weeks.

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16
Q

T/F? Neurosyphilis only occurs with late syphilis.

A

False - can occur any time during course of infection

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17
Q

Early neurosyphilis includes what manifestations?

A

Asymptomatic/symptomatic meningitis, stroke, vision or hearing loss.

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18
Q

Late neurosyphilis includes what manifestations?

A

Involves brain and spinal cord - dementia, paresis, tabes dorsalis.

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19
Q

Treatment for neurosyphilis?

A

Aqueous pen G 3-4 million units IV every 4 hours for 10-14 days.

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20
Q

Syphilis infections of the ___ or ___ should always be treated as neurosyphilis.

A

eye or ear

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21
Q

What are the options for the first test you would do if you suspect syphilis?

A

VDRL ( venereal disease research lab test)
OR
RPR (rapid plasma reagin test)

22
Q

If you got a positive test, what do you do next?

A

Confirmatory treponemal test

23
Q

What are the options for confirmatory treponemal tests?

A

TP-PA
FTA-ABS
TP-EIA
CIA

24
Q

Testing for gonorrhea?

A

NAAT preferred - vaginal swab in women, urine in men.

25
Q

Tx for gonorrhea?

A

Ceftriaxone 500mg IM

26
Q

If a patient needs to be treated for gonorrhea, and chlamydia has not been ruled out, does it change your treatment?

A

Yes - treat with ceftriaxone 500mg IV + doxy 100mg BID x 7 days

27
Q

Testing for chlamydia?

A

NAAT - vaginal swab in women, urine sample for men.

28
Q

Treatment for chlamydia?

A

Two first line options,
Azithromycin 1g PO
OR
Doxy 100mg PO BID x 7 days

29
Q

T/F? Herpes infections can cause constitutional symptoms.

A

True - but they don’t always cause constitutional symptoms.

30
Q

Recurrent herpes infections present with what type of lesions?

A

Small vesicular or ulcerative lesions. Vulvar irritation or fissures possible.

31
Q

T/F? If your patient is diagnosed with herpes, it is important to tell them it is a lifelong infection.

A

True

32
Q

What test is most commonly done to test for herpes?

A

Viral culture from vesicle fluid

33
Q

What is the most sensitive and specific test for herpes?

A

PCR

34
Q

What is the gold standard for herpes testing?

A

Tzank smear

35
Q

What findings on a Tzank smear indicate herpes infection?

A

Multinucleated giant cells

36
Q

Treatment for herpes?

A

Acyclovir or valacyclovir for flares and suppression if 6+ flares per year

37
Q

Describe the discharge of BV.

A

Thin off white vaginal discharge with a fishy odor

38
Q

What criteria can you use to diagnose BV?

A

Amsel criteria

39
Q

List the Amsel criteria.

A

Homogenous thin white/grey discharge that coats vaginal wall
Vaginal pH > 4.5
Positive whiff amine test with 10% KOH solution
Clue cells on saline mount, at least 20% epithelial cells

40
Q

How many of the Amsel must be met to dx BV?

A

3/4

41
Q

Tx for BV?

A

Metronidazole or clindamycin

42
Q

Describe the discharge of candidiasis.

A

Cottage cheese like thick, white.

43
Q

What are some associated symptoms with the discharge in candidiasis?

A

Intense pruritis, could have excoriations with bleeding.
Dysuria
Dyspareunia

44
Q

What do you need to diagnose candidiasis?

A

Went mount with budding yeast and hyphae on KOH prep

45
Q

Tx for candidiasis?

A

Oral fluconazole or topical clotrimazole or miconazole.

46
Q

Why do you need to exercise caution when prescribing fluconazole?

A

A lot of DDIs

47
Q

Describe the discharge with trichomoniasis

A

Malodorous greenish-yellow thin discharge.

48
Q

Cervical appearance with trichomoniasis?

A

Strawberry cervix

49
Q

Gold standard trich testing?

A

NAAT

50
Q

Wet mount of trichomonas shows?

A

Flagellated trichomonads

51
Q

Tx for trich?

A

Metronidazole or tinidazole x 7 days

Cam's Cards COPY (93 decks)

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